MEDICARE: KATHLEEN HARVEY M.S E.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1518683697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN HARVEY M.S E.D

Provider Business Mailing Address
First Line	:	2103 31ST AVE # 5A
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-4521
Country	:	US
Telephone Number	:	631-338-7682
Fax Number	:

Provider Business Practice Location Address
First Line	:	2103 31ST AVE # 5A
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-4521
Country	:	US
Telephone Number	:	631-338-7682
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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